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Detection of Helicobacter pylori in stool specimens by non-invasive antigen enzyme immunoassay in children: multicentre Italian study

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7231.347 (Published 05 February 2000) Cite this as: BMJ 2000;320:347
  1. Giuseppina Oderda, researcher (oderda@med.unipmn.it)a,
  2. Anna Rapa, headb,
  3. Barbara Ronchi, research fellowa,
  4. P Lerro, medical assistantc,
  5. Maria Pastore, medical assistantd,
  6. Annamaria Staiano, researchere,
  7. G L de'Angelis, researcherf,
  8. P Strisciuglio, director of paediatric departmentg
  1. a Paediatric Endoscopy Units, Università del Piemonte Orientale, 28100 Novara, Italy
  2. b Paediatric Research Laboratory, Università del Piemonte Orientale
  3. c Paediatric Endoscopy Units, Turin University, Piazza Polonia 94, 10126 Turin
  4. d Paediatric Endoscopy Units, Viale Cappuccini, 71013 San Giovanni Rotondo
  5. e Paediatric Endoscopy Units, Naples University, Via Pansani 5, 80131 Naples
  6. f Paediatric Endoscopy Units, Parma University, Via A Gramsci 14, 43100 Parma
  7. g Paediatric Endoscopy Units, Via T Campanella, 88100 Catanzaro
  1. Correspondence to: G Oderda
  • Accepted 7 October 1999

Helicobacter pylori infection is mainly acquired in childhood and may predispose to peptic ulcer or gastric cancer later in life.1 Non-invasive diagnostic tools are particularly useful in children as screening tests and for epidemiological studies, but their accuracy has to be tested against that of invasive tests in symptomatic patients before they are used in any particular population.

Of the non-invasive tests now available, serological testing is not accurate in young patients and the 13C urea breath test is expensive. In 1998 an enzyme linked immunoassay (ELISA) (Premier-Platinum-HpSA, Meridian Diagnostics, Cincinnati, OH, USA) was approved by the Food and Drug Administration for both diagnosis in adult symptomatic patients, and monitoring the response to treatment. It is now commercially available, but its correlation with gastric infection has not been assessed in children. We evaluated its diagnostic accuracy against invasive tests in children undergoing endoscopy for clinical evaluation, and we determined the cut off values for the paediatric population.

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Test performance calculated according to different reading techniques (at 450 …

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